A who's who of health care reform

After months of committee work, Senate Majority Leader Harry Reid of Nevada and Speaker Nancy Pelosi of California are driving the debate on health care reform, but they are each relying on a cast of supporting actors.

If the Democratic leadership expects to pass the most far-reaching legislation in 40 years, it needs an assist from a bona fide deal maker such as Sen. Chuck Schumer and an emerging one such as Sen. Tom Carper. There are also wild cards, progressive loyalists, centrist doubters and 2010 targets who will each shape the health care bill.

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Reid, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Sen. Chris Dodd (D-Conn.) have played outsize roles in shaping the legislation to this point, and they are likely to maintain their influence by managing the legislation on the floor later this month. In the House, Pelosi showed she could corral her disparate caucus and position Democrats to pass a bill as early as next week.

Here’s a look at key players beyond the top tier:

Sens. Chuck Schumer (D-N.Y.) and Tom Carper (D-Del.)

While political commentators administered last rites to the public insurance option in late September, these two senators were quietly giving it new life. Concerned about the hardened lines in the debate, Carper began floating an alternative proposal allowing states to create their own competitor to private insurance. Schumer then suggested that states be allowed to opt out of a national plan. As two senators who represent different wings of the Democratic caucus — Schumer is a liberal, Carper is a moderate — they will continue to play a key role threading the needle on the issue.

Sen. Sherrod Brown (D-Ohio)

He has emerged as a leading liberal voice in the Senate on health care. When President Barack Obama sounded noncommittal on the public option, Brown predicted he would come around. When the White House made conflicting statements about an $80 billion deal with the pharmaceutical industry, Brown called it on it. When the media raised doubts about the political viability of a public option, Brown countered that a majority of Democrats backed the proposal. As a member of the Senate health committee, he co-wrote with Sen. Sheldon Whitehouse (D-R.I.) the public insurance option that Reid placed into the merged Senate bill. Brown has established himself as the go-to spokesman on the progressive side of the scale.

Sen. Ben Nelson (D-Neb.)

He does this every time, Senate aides grumble privately. Whenever major legislation emerges, Nelson raises objections until leaders make modifications to his liking. And it’s true again: Nelson is the focus of a Senate whip count on health care. He is a conservative in a liberal-leaning caucus, a Democrat from a Republican state who is more concerned about cost than coverage. He is likely to be a holdout until the very end, making Reid and Obama work hard for his vote.

Sen. Blanche Lincoln (D-Ark.)

She represents the endangered 2010 class of incumbents, a Democrat up for reelection being asked to cast politically difficult votes on what could be a partisan bill. Senate Minority Leader Mitch McConnell of Kentucky raised the stakes last week when he said Republicans will argue on the campaign stump that a vote to proceed to the bill is a vote in favor of health care reform. Reid will keep Lincoln close in his sights as he moves the bill through the Senate, hoping to minimize her exposure while still getting what he needs.

Sen. Olympia Snowe (R-Maine)

Snowe invested months in the Finance Committee negotiations, gave Democrats a blush of bipartisanship by voting for the bill and was essentially cast aside. She doesn’t support a government-sponsored public option and appeared personally disappointed at Reid’s decision to include it rather than her idea for a “trigger” that would create one only if the private market failed to expand coverage. “The leader said it was a doggone good idea, my trigger. That is what he said in September,” Snowe said. But few expect her to stay on the sidelines indefinitely. Carper is already working on an alternative to the opt-out public option aimed at winning centrists like Snowe if Reid’s opt-out strategy comes up short of 60 votes.